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[4] Red flag symptoms requiring immediate medical assessment include: progressive or worsening neurological symptoms, changes in vision, significant gait disturbance, or cognitive decline

& Gonzalez, J

It may affect a few joints (i.e., monoarticular or localized JHM) or present in multiple body sites (i.e., generalized or general JHM)

The deceleration is not a failure

"Pre-conception Folic Acid and Multivitamin Supplementation for the Primary and Secondary Prevention of Neural Tube Defects and Other Folic Acid-Sensitive Congenital Anomalies"